ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The expanding use of newer coronary artery intervention modalities in the treatment of critically ill cardiac patients has produced a profound change in the manner in which acute care is rendered to these patients. To meet the needs of community hospitals and to improve the safety of interfacility transport to tertiary care centers, a transport program was developed at The Hospital of the Good Samaritan, Los Angeles, California. Rapid transport by helicopter, fixed-wing aircraft or specialized ground ambulance services has been used to improve patient transit time and safety of transfer between the community hospital and tertiary care facility. Experience at The Hospital of the Good Samaritan (1,012 consecutive patients) compares favorably with other programs and proves to be safe and beneficial.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Ventricular assist devices serve as a valuable adjunct to therapy in the setting of profound heart failure. The two largest patient groups—postcardiotomy and those being bridged to transplant—show an average 40–50% survival rate after ventricular assist. Several devices exist including centrifugal, pneumatic, and electrical pumps. Options for ventricular assist include right (RVAD), left (LVAD), and biventricular (BiVAD) support. Knowledge regarding the devices and the pathophysiology of severe heart failure is crucial for the critical care nurse caring for these patients. Critical care nursing interventions for bleeding, renal failure, infection, and other complications will be outlined.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The nursing care of the patient with dilated cardiomyopathy focuses on (1) improving right and left heart function, i.e., titrating vasoactive drugs to maintain acceptable cardiac index with minimum side effects (and/or monitoring the operation of a left ventricular assist device when left heart function is refractory to vasoactive drugs), (2) reducing cardiac filling pressures with diuretics, vasodilators, and/or restriction of dietary sodium, oral and IV fluids, (3) maintaining optimum oxygenation, (4) preventing complications associated with either the disease or treatment, and (5) assisting the patient/family to maintain hope during the often lengthy and crisis-filled wait for a donor heart. The critical care nurse is challenged, often for weeks or months at a time, by the complexity of this patient's physical and emotional needs and functions in a collaborative role with the entire health team in an attempt to maintain both cardiovascular and psychological stability until a donor heart is available.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The underlying principle of the Fontan procedure, perfusing the lungs without benefit of a ventricular pump, has been reinforced by its successful application in many children with complex cardiac anomalies involving only one functional ventricle. Several different techniques that direct systemic venous return through the right atrium directly to the pulmonary arteries can be used. By separating the pulmonary and systemic circulations, reducing ventricular volume overload, and relieving cyanosis, improved cardiac function and hemodynamics can be achieved. This article reviews the surgical techniques, perioperative nursing care with particular attention to the assessment, and management of systemic venous hypertension and the longterm outlook for these children. The collaboration of physicians and critical care nurses in the postoperative care of these children and their families is vital to a successful outcome.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Retrograde coronary sinus perfusion is a technique being used to deliver cardioplegia during cardiac surgery. This article reviews the history behind its use, the procedure for delivery, and the advantages and limitations that exist in comparison with the standard antegrade infusion of cardioplegia via the aortic root. The complications resulting from the technique of retrograde coronary sinus perfusion are rare. Nursing considerations specific to the potential complications of this patient population are discussed.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Deaths related to the recreational use of cocaine in the United States have increased to epidemic proportions within the last decade. Frequently, persons with cocaine toxicity present to the emergency room, require critical care nursing, and are admitted to the intensive care unit. This article outlines the cardiovascular effects of recreational cocaine abuse. Initially, the historical perspective of the drug is outlined. The mechanism of action, administration, absorption, and excretion are discussed. Details regarding the cardiovascular effects of cocaine are described. Although no uniform treatment plan has been developed for every complication of cocaine overdose, the current therapeutic modalities are outlined. Finally, the clinical implications for clinical practice are addressed. The recreational abuse of cocaine presents new patient care challenges for the critical care nurse. With increased knowledge, the health care provider may assist in meeting the clinical needs of this emerging patient population.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The subject of cardiac reoperation in general has been infrequently discussed in the medical literature and has not yet appeared in the nursing literature. Yet reoperation presents a real challenge, accentuating some problems that are also associated with primary cases and posing some considerations that are unique to the reoperative situation. The objectives of this article are to discuss the reasons prompting reoperation for coronary revascularization, identify technical problems associated with reoperative coronary artery surgery, explore potential avenues for decreasing the need for reoperation, and discuss potential patient care problems in the immediate postoperative critical care setting.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The signal-averaged electrocardiogram (SAE) is a noninvasive means of detecting cardiac late potentials. Late potentials in patients with coronary artery disease indicate a high risk for the development of ventricular tachycardia. Although the usefulness of the SAE for directing-therapy has not yet been clearly established, the test appears to be useful in the stratification of arrhythmia risk in select groups of high-risk patients. As critical care nurses frequently care for these patients, they need to be familiar with tools such as the SAE that may be used in high-risk patient assessment. This article describes the physiologic basis underlying the use of the SAE, the SAE technique, implications for nursing practice, and clinical applications of the SAE.

ISSN:1046-7467    

出版商:OVID    

年代:1990

数据来源: OVID